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Senator Spilka to Testify on Women’s Health and Cancer Recovery Bill

November 9, 2009

November 9, 2009

Senator Karen Spilka (D-Ashland) will testify before the Joint Committee on Public Health tomorrow on Senate Bill 896, An Act Relative to Women’s Health and Cancer Recovery. Senator Spilka’s bill seeks to put an end to “drive through mastectomies.”

Specifically this bill calls for health insurance plans to provide coverage for a hospital stay in relation to inpatient hospital care of mastectomy, lumpectomy, and lymph node dissection for the treatment of breast cancer.

“This bill would prohibit health insurance plans from rewarding or penalizing doctors based upon length of recovery time for a patient,” stated Senator Spilka.

Currently, Massachusetts law does not require insurance companies to provide inpatient care related to the treatment of breast cancer. The practice of performing mastectomies on an outpatient basis has been referred to as “drive through mastectomies.”

“Breast cancer patients are forced to leave the hospital shortly after receiving a mastectomy and are still groggy from anesthesia and in a lot of pain,” stated Senator Spilka.

This bill would also require coverage for secondary consultations, reconstructive surgery, prosthetic devices, and lymph edema therapy. Current law does not require insurance companies to provide coverage to breast cancer patients who want to seek a second opinion, either medical or surgical.

Second opinions are considered vital due to the fact that a small but significant number of biopsies are regularly misinterpreted, according to a Johns Hopkins research study. Most large insurance providers in Massachusetts currently do provide coverage for a second opinion from a specialist inside of the provider network. However, these same providers often do not grant coverage for out-of-network second opinions.

“Out-of-network opinions are critical to aid women in obtaining a diverse view point on her diagnosis.” stated Senator Spilka. Doctors from the same network will often have the same perspective on a diagnosis if they are coming from similar training, residing in the same general geographic area, and working within the guidelines of the same network.

Currently the Federal government is working to improve breast cancer patients’ treatment during their surgeries through the Breast Cancer Patient Protection Act. If this bill is passed, insurance companies and providers will be required to allow patients who have received a mastectomy a 48 hour stay in the hospital. While this new law would be a great improvement, Senator Spilka believes her bill to be better. “My bill requires that the recovery time in a hospital be determined by the physician and the patient, not an insurance company.”

Right now there are twenty states that have a mandate for minimum inpatient coverage after a patient undergoes a mastectomy.

“As a leader in health care, Massachusetts should not wait for federal legislation to guarantee compassionate treatment,” stated Senator Spilka. My bill would let Massachusetts join these 20 states in assuring that women have a proper chance to recover.”